Antimony in drinking-water
Background document for development of WHO Guidelines for Drinking-water Quality
Effects on Humans
The toxicity of antimony is a function of the water solubility and the oxidation state of the antimony species under consideration (Elinder & Friberg, 1986; Fowler & Goering, 1991). In general, antimony(III) is more toxic than antimony(V), and the inorganic compounds are more toxic than the organic compounds (Stemmer, 1976), with stibin (SbH3), a lipophilic gas, being most toxic (by inhalation).
Soluble antimony salts, after oral uptake, exert a strong irritating effect on the gastrointestinal mucosa and trigger sustained vomiting. Other effects include abdominal cramps, diarrhoea and cardiac toxicity (Elinder & Friberg, 1986). The minimal lethal dose for oral intoxication by antimony in the form of APT (tartar emetic) is reported in textbooks as 300 mg of APT for a child and 1200 mg of APT for an adult. The acute symptoms are similar to those seen after acute oral intoxication by arsenic (Wirth, 1994).
Chronic respiratory uptake of antimony-containing dusts leads to irritation of the respiratory tract and myocardial and liver damage (Elinder & Friberg, 1986; Winship, 1987).
With respect to possible reproductive effects of antimony in humans, one incomplete study reported that respired antimony compounds could trigger premature births and spontaneous abortions (Belyeava, 1967).
Repeated oral exposure to therapeutic doses of antimony(III) was associated with optic nerve destruction, uveitides and retinal bleeding. Specific symptoms of intoxication are generally accompanied by headache, coughing, anorexia, troubled sleep and vertigo (Stemmer, 1976).
Significant induction of chromosomal aberrations and micronuclei was reported in 15 patients given therapeutic doses of APT (Hashem & Shawki, 1976). In a case-study of a patient suffering from visceral leishmaniasis and treated with meglumine antimoniate (antimony(V)), the authors reported an increase in the number of cells with micronuclei, but no changes in sister chromatid exchange or structural aberrations in chromosomes in the lymphocytes (Hantson et al., 1996). On the basis of these findings, the authors concluded that this compound did not represent a mutagenic or carcinogenic risk to humans.
Inhalation exposure to ATO in workplaces was associated with increased incidences of lung cancer, but not with tumours of other organs (Elinder & Friberg, 1986).